Adjuvant chemotherapy in lobular carcinoma of the breast: a clinicopathological score identifies high-risk patient with survival benefit.
Breast Cancer Res Treat
; 175(2): 379-387, 2019 Jun.
Article
em En
| MEDLINE
| ID: mdl-30759288
ABSTRACT
BACKGROUND:
Invasive lobular carcinomas (ILCs) represent approximately 10% of all breast cancers. Despite this high frequency, benefit of adjuvant chemotherapy (CT) is still unclear.METHODS:
Our objective was to investigate the impact of CT on survival in ILC. Patients were retrospectively identified from a cohort of 23,319 patients who underwent primary surgery in 15 French centers between 1990 and 2014. Only ILC, hormone-positive, human epidermal growth factor 2 (HER2)-negative patients who received adjuvant endocrine therapy (ET) were included. End-points were disease-free survival (DFS) and overall survival (OS). A propensity score for receiving CT, aiming to compensate for baseline characteristics, was used.RESULTS:
Of a total of 2318 patients with ILC, 1485 patients (64%) received ET alone and 823 (36%) received ET + CT. We observed a beneficial effect of addition of CT to ET on DFS and OS in multivariate Cox model (HR = 0.61, 95% confidence interval, CI [0.41-0.90]; p = 0.01 and 0.52, 95% CI [0.31-0.87]; p = 0.01, respectively). This effect was even more pronounced when propensity score matching was used. Regarding subgroup analysis, low-risk patients without CT did not have significant differences in DFS or OS compared to low-risk patients with CT.CONCLUSION:
ILC patients could derive significant DFS and OS benefits from CT, especially for high-risk patients.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Quimioterapia Adjuvante
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Carcinoma Lobular
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Carcinoma Ductal de Mama
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article